What is the best way to treat fat necrosis and a seroma?

Question

I had a Tummy Tuck with Liposuction 3 1/2 months ago i've been having problems. I had to go several times to my PS for aspiration of a seroma in my back and abdomen. At 4-5 weeks post-op i started feeling a hard lump/ball from my bb to my tt incision. I went to get an ultrasound and they told me i have fat necrosis and underneath it i have fluid. I went back to my PS and he wants to do a revision. He wants to reopen my incision but i dont know if that is the best option?

Brent Moelleken, MD · Answer

Sorry to hear about your problems!  You may be comforted to know that every doctor gets a complication from time to time, and it's how they handle the complication that is important.  It sounds as though your surgeon is doing his best to treat your issues.Often, time and conservative care will allow the body to reduce the scope of any revisions.  Sometimes, revisions can be completely prevented by a patient approach.If you have doubts as to how things are going, you may want to seek a second opinion.However, assuming your surgeon is well trained and caring, it is usually best to continue your care with the initial doctor until the problem is fully resolved.

Salvatore Pacella, MD, MBA, FACS · Answer

If there is a lot of fluid present (i.e. you can feel and see the fluid), then a conservative aspiration is recommended.  Fat necrosis, by itself, is not a true emergency.  If there is no infection or open wound, it may be best to watch this conservatively.  Massage will definitely help.  It may not completely remove the lump, but time and massage will make it a bit smaller.  If given a sufficient amount of time, a small excision may be warranted.

Stephen M. Davis, MD, FACS · Answer

Thanks for writing,When a person has a tummy tuck the skin is lifted from the belly wall. There are now two raw surfaces, the bottom of the elevated skin and the belly wall. When the skin is re-draped the two surfaces have to stick together. Placing a drain helps by removing the fluid that comes from these raw surfaces. Over time the surfaces stick together, the drain is removed and the body heals itself.Periodically a pocket of fluid can form that doesn't get drained or drain well. Sometimes some of the fat ( on the bottom of the skin) may not do well and dies ( fat necrosis) / scars. One of the goals of a tummy tuck is improved contour ( smooth, flat, tight belly wall). Seromas and fat necrosis can change the appearance of your belly wall.I would follow the advice of your Plastic Surgeon, he / she is just trying to give you the best outcome possible. Sometimes things happen no matter how hard we try to get everything we want.  What your Plastic Surgeon wants to do is carry that t the next level, manage the problem and get a great result. Good LuckI hope this helpedStephen M. Davis, MD, FACSGreen Hills Plastic Surgery

Heather J. Furnas, MD · Answer

It is normal to be reluctant to have another procedure so soon after having had a tummy tuck and liposuction. However, 3 1/2 months is a long time to still be battling with complications. Ask your plastic surgeon specifically why he/she thinks surgery is the best approach and what would happen if you didn't have surgery. Ask what the potential complications are for each approach, surgical and non-surgical. Once you understand the big picture, your decision to have surgery (or not) will be easier.Once you have healed, review your before photos and compare them with your after photos so you can see the difference! (See link below.)Good luck.

What is the best way to treat fat necrosis and a seroma?

Answers (4)

Answer: Tummy Tuck Complication--Should Patient Have a Revision?

Answer: Tummy Tuck Complication--Should Patient Have a Revision?

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What is the best way to treat fat necrosis and a seroma?

Answers (4)

Answer: Tummy Tuck Complication--Should Patient Have a Revision?

Answer: Tummy Tuck Complication--Should Patient Have a Revision?

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Recommended reading

Everything you need to know about Tummy Tuck

Our mission is to create a world where every investment in modern beauty is Worth It.